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BASICS

Sodium
Sodium is a basic element commonly referred to as salt or sodium chloride. Although the terms are often used interchangeably, salt and sodium chloride actually contain different amounts of sodium. 2.5 grams of salt is equal to 1 gram of sodium. Sodium is used in preservatives to inhibit growth of food-borne pathogens, as well as an additive that modifies flavor, enhances color, and serves as a stabilizer. Most salt originates in food in a natural form, but while cooking or processing foods, we tend to add more salt to them. High levels of sodium that are added to these food items has been causing an increase of salt intake across the nation. The current average intake for people over the age of 2 years old is about 3,200 mg/day, while recommendations are less than 2,300 mg/day for a healthy individual under the age of 50.

Small amounts of sodium are a necessity in the body. Sodium is a component of the blood and is an important factor in maintaining daily body functions. Sodium contributes to electrical impulses in nerves and muscles and provides gradients for nutrients to move within the body.

Below are links that provide further information on the importance of salt within the body.
http://www.merckmanuals.com/home/hormonal_and_metabolic_disorders/electrolyte_balance/sodium.html
http://www.medicalnewstoday.com/articles/13273.php

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Sodium and Water
Water is a necessary component in the body used to help maintain normal blood pressure within the vessels. In addition, water helps regulate homeostasis and other basic functions. Excess water is retained when sodium levels within the body are too high. This can cause cells to swell which may lead to an increased risk for medical conditions such as high blood pressure (hypertension).


CAUSES

Why Does Sodium Cause Hypertension (HTN)?
High salt intake can cause hypertension due to the water retention within the cells of our body. When the cells retain more water, the pressure within the blood vessels also increases. This, in turn, causes a condition called hypertension. Hypertension occurs when hardened arterial walls causes blood to flow harder and faster than required.

Below are links to an article and a scientific journal that describe the effects of sodium and hypertension in greater detail.

http://www.webmd.com/hypertension-high-blood-pressure/guide/understanding-high-blood-pressure-basics

This is a video regarding the effects of salt on the body. In addition, statistics are included that indicate the prevalence of salt intake in America.



















COMPLICATIONS

Low Sodium Complications:
Hyponatremia is the condition of a low sodium concentration in the body. This means that in a given cell there is more water than sodium. To correct hyponatremia the body can either increase sodium levels within the cell or decrease the water volume. While most cells can handle the adjustment, brain cells cannot. Because of this, brain injuries or complications are the most likely outcome of hyponatremia. There are three types of hyponatremia that result from an imbalance of water to salt: euvolemic (body water increases, but sodium levels stay constant), hypervolemic (sodium and water levels increase in the body, but water has a greater increase), and hypovolemic (sodium and water are lost, but water to a lesser extent).

Below are links that convey more information about hyponatremia, including causes, symptoms, and treatment.
http://www.healthline.com/channel/low-sodium-in-blood-hyponatremia_complications
http://www.nlm.nih.gov/medlineplus/ency/article/000394.htm

High Sodium Complications:
Hypernatremia is the condition of high salt concentrations within the body. Hypernatremia is classified as having levels above 136-145 mEq/L. Hypernatremia can be caused by several factors including dehydration, medications,a salt rich diet, and hyperventilation.

Below are links that provide more information about hypernatremia, including symptoms, treatment and medications.
http://www.chemocare.com/managing/hypernatremia-high-sodium.asp

MANAGEMENT

How Much Sodium Should I Consume?
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Although no minimum or maximum level of sodium intake have been set, the USDA Recommended Daily Allowance for a healthy adult is no more than 2,400 mg/day. This is about a teaspoon of table salt. The Food and Nutrition Board of the National Academy of Sciences suggests that a daily minimum of 500 milligrams (mg) is necessary for proper body function. Adults with hypertension should consult their doctor to determine their sodium limitations.

Common Foods High in Sodium
  • Sauces/Dressings
  • Processed Meats
  • Canned Soups
  • Salted Snacks
  • Pickled Food
  • Dairy (especially processed cheese)
  • Cereals
  • Ready-to-eat meals
  • Drinks (soft-drinks and flavored powder drinks- i.e., Kool-Aid, hot cocoa, tea, etc.)
  • Canned Vegetables

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Reduce Your Dietary Sodium Intake

Individuals with high blood pressure are advised to lower the amount of sodium in their diets. Lowering intake of high sodium foods has been shown to have blood pressure lowering benefits. Lower-sodium diets can also help keep blood pressure from rising and help blood pressure medications work.

Link to three excellent articles that provides information and tips on how to gradually reduce your sodium intake and manage a low sodium diet.

http://www.mayoclinic.com/health/sodium/NU00284
http://my.clevelandclinic.org/health/diseases_conditions/hic_Hypertension_High_Blood_Pressure/hic_High_Blood_Pressure_and_Nutrition
http://www.webmd.com/diet/features/5-easy-ways-to-cut-back-on-salt


DIETARY MODIFICATIONS

Tips for Preparing Lower Salt Meals:
  • Add less salt at the table AND in cooking. Try seasoning with spices and herbs instead.
  • Try a salt-free seasoning/marinade such as Mrs. Dash
  • Do not add salt until you try your food. Do not assume it needs to be added to be palatable.
  • Cook with low-salt ingredients and remove salt from recipes whenever possible. For example; rice, pasta, and hot cereals can be prepared without salt.
  • Use fewer sauces, mixes, and “instant” products. This includes: flavored rices, pasta, and cereal. These usually have added salt.
  • Rinse the salt from canned foods. For example, strain your canned vegetables and beans.
  • Limit intake of smoked, cured, or processed beef, pork, or poultry.
  • Buy fresh, plain frozen (unflavored/unseasoned), or canned “with no salt added” vegetables.
  • Use salt substitutes (potassium chloride instead of sodium chloride) that will add the same taste. These must be added after cooking and have other health benefits. To learn more visit:http://www.hsph.harvard.edu/nutritionsource/salt-and-sodium/take-action-on-salt/
  • A general diet modification is the DASH diet. Read more about this here: http://www.nejm.org/doi/full/10.1056/NEJM200101043440101

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Reading Nutrition Facts Labels
In order to effectively manage your sodium intake it is important to pay attention to the amount of sodium contained in the foods you consume each day. Look for foods that are labeled as low-sodium, very low sodium, salt-free, light in sodium, and reduced sodium. Also, be sure to watch out for words that indicate high sodium content.

http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm


Key Terms
Low-sodium: food has 140 mg or less of sodium per serving
Very low sodium: food has 35 mg or less of sodium per serving
Salt-free: food has 5 mg or less of sodium per serving
Light in sodium: food has at least 50% less sodium than the original version of the food
Reduced sodium: food has at least 25% less sodium than the original version of the food
http://www.cancer.org/healthy/eathealthygetactive/takecontrolofyourweight/understanding-food-labels

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Words to Watch Out For
  • monosodium glutamate (MSG)
  • sodium benzoate
  • sodium hydroxide
  • sodium nitrite
  • sodium proprionate
  • disodium phosphate
  • sodium sulfate

Nutrition facts labels containing the above ingredients indicate that the food has a high sodium content.

This video shows how to read and understand food nutrition fact labels to help manage sodium intake. It also provides other helpful information on lowering sodium intake to manage hypertension. http://www.youtube.com/watch?v=x6QMgAFvbKA&feature=related


FOODS TO AVOID

Follow this link for advice to reduce sodium intake: http://www.youtube.com/watch?v=CJUNEg65YFw.
For a list of common foods high in sodium please visit: https://healthy.kaiserpermanente.org/health/care
For another place to find a list of high sodium foods visit: http://www.healthaliciousness.com/articles/what-foods-high-sodium.php
WebMD has a great slideshow of hidden sources of sodium: http://www.webmd.com/diet/slideshow-salt-shockers.

SOURCES
http://www.lenntech.com/periodic/water/sodium/sodium-and-water.htm
http://www.annecollins.com/diet-for-high-blood-pressure.htm
http://www.google.com/images